Gaby Novoa highlights new research on “military literacy” among pediatricians.
November 10, 2021
STUDY: Heidi Cramm, PhD, OTReg (Ont.); Alyson Mahar, PhD; Linna Tam-Seto, PhD, OTReg (Ont.); Anne Rowan-Legg, MD, FRCPC, “Caring for Children and Youth from Canada’s Military Families,” Paediatrics & Child Health (July 2021). Link: https://bit.ly/3EYJpo3.
Military families face a unique combination of stressors that can affect the health and development of children and youth, including frequent relocations; regular parental absences; and risk of illness, injury or death for the serving family member. Research has shown that, while children in military families receive care from the same provincial/territorial health care providers as civilians, they face difficulties re-establishing medical services after relocation and are less likely to have a family doctor.1 Furthermore, many pediatricians have little, if any, awareness of the unique experiences and realities of military families and the kinds of focused support they can provide.
In “Caring for Children and Youth from Canada’s Military Families,” Heidi Cramm et al. explore the knowledge and experiences of pediatricians who provide care to CAF families through a targeted survey. The study highlights a need to build military literacy among pediatricians – awareness and understanding of the unique experiences, strengths, vulnerabilities and perspectives common among military families – and the authors provide direction for the development of enhanced resources and supports.
Military families have unique challenges in health care
Compared with civilian families, research has shown that military families in Canada are less likely to access medical care and that many have reported finding it extremely difficult to re-establish medical services after relocation.2 With military families being three to four times more likely than civilians to relocate, continuity of care can be challenging because each move can mean having to transfer medical records, move from one waiting list to another and establish new relationships with health care providers.
This can be compounded by the fact that many Canadian Armed Forces (CAF) communities are in rural settings, where access to specialists and certain diagnostic tests and/or treatments is relatively limited. Quality of care is further affected when there is a lack of understanding among medical practitioners of military family experiences and challenges, and how these factors inform and influence the care required for children and youth.3
Study confirms knowledge gaps about CAF families among many pediatricians
Cramm et al. distributed the survey to all pediatricians and pediatric specialists registered with the Canadian Paediatric Surveillance Program (CPSP). A total of 774 (28%) completed surveys were received,4 in which:
- One-third (32%) incorrectly believed that CAF families receive services from the federal military health care system.
Military families, including children and youth, do not have access to federal military health care, which is available only to active members of the CAF. Children and youth from military families rely on the same provincial and territorial health care providers as other Canadians.
- Nearly one-quarter (23%) said they did not feel that identifying for military status informed patient care.
Although some participants reported that they have made efforts to screen for health and social history, about one in four pediatricians indicated that they did not feel that being from a military family would inform or have an impact on how they delivered care.
- Over half (56%) said they do not feel adequately prepared to provide care to CAF families.
Only 2% of respondents stated that they had received any specific training or education related to military families, while 18% reported that they were aware of the Canadian Paediatric Society’s 2017 position statement on caring for children and youth in military families. The position statement outlines special considerations for pediatricians who serve them and the importance of understanding their unique contexts.
Opportunities for enhanced training and supports
The authors identified several opportunities to expand and enhance resources and training related to military family experiences and to the impacts on children and youth. They cite an educational framework developed in the United States to provide nursing students with a range of learning possibilities, including direct engagement with Veterans by hearing their personal stories and meeting them within health care contexts.5 The authors suggest that this framework could inspire a similar training program in Canada for physicians undergoing training in pediatrics. Partnerships with Military Family Resource Centres (MFRC) across Canada can support the development and implementation of initiatives to increase military family awareness, as well as resources such as Family Physicians Working with Military Families.
Other organizational efforts to provide education to health practitioners are noted, including resource documents that have been developed for therapists working with military members, Veterans and their families. This work provides a starting knowledge base that can be expanded upon and specialized for those working with children and youth from military families.
In particular, they highlight two important resources from the Canadian Paediatric Society:
- Improving the Health Care of Canadian Military Families, an online educational module/case-based curriculum to improve the clinician’s ability to provide care to Canadian military families
- Caring for Children and Youth from Canadian Military Families: Special Considerations, a podcast created to increase the military literacy of pediatricians
This study provides important insights into the lives of military families in Canada and an understanding of those who provide them with care. Further research on the experiences of military families and on the “military literacy” of those who serve and support them will play an essential role in ensuring and supporting their health and well-being.
Gaby Novoa is responsible for communications and publications at the Vanier Institute of the Family.
This research recap was reviewed by Heidi Cramm, PhD, OTReg (Ont.) and Linna Tam-Seto, PhD, OTReg (Ont.).
- Learn more about military and Veteran families and family experiences in “A Snapshot of Military and Veteran Families in Canada,” The Vanier Institute of the Family (2018). Link: https://bit.ly/3BUCg7g.
- Learn more in “Family Physicians Working with Military and Veteran Families,” The Vanier Institute of the Family (2016). Link: https://bit.ly/3jxXT6n.
- Anne Rowan-Legg, “Caring for Children and Youth from Canadian Military Families: Special Considerations,” Paediatrics and Child Health (2017). Link: https://bit.ly/3vftYo6.
- The authors acknowledge in this study that this response rate may mean that the survey participants are not representative of the full spectrum of practising pediatricians and pediatric specialists in Canada: “the response rate of 28% for this survey is slightly lower than the average response rates of CPSP surveys between 2016 and 2018 (32%); however, it was higher than the approximate 20% response rate cited in literature on research surveys.”
- The framework is known as Project SERVE (Students’ Education Related to the Veteran Experience), developed by nursing programs at Auburn University, Auburn University Montgomery and Walter Reed National Military Medical Center.